EFTA00035225

.RVATION LOG _Y I NAME: C . ES±e REGiSTRATIONtf: 7(.2-6 I & 0 sel OBSERVATION STARTED:_ 7 - 2‘1 — 20. Ict PLEASE RETURN LOG TO PSYCHOLOGY AFTER THE OBSERVATION HAS ENDED. THANK YOU. crguis ALLOWED: • fr\s I' Regular Clothes • 71 - Safety Toothbrush .. i r Newspaperfivlagazine O00kS (softcover only), ) v Safety Pen and Paper Toilet Paper Mail Other SW Blanket & SW Mattress must he used even on Psych . Observations. If nothing is checked with a silver marker, only a Suicide Smock and Suicide Blanket.: re allowed. EFTA00035225 Name of Inmate On Suicide Watch or Psych Observation: e;adf if Registration It: 9 -6 pjr EATING/SHOWER CHART DATE BREAKFAST LUNCH DINNER LIQUIDS OFFERED SHOWER RECEIVED SHOWER / V — IV" t7 - e.--t./ 19 j,,,,er• - e‘.2. '• (/ / li WM • , — _ Please check the appropriate box if the person on 'Suicide Watch/Psych Observation actually eats his meal. Do not check the box if helust received it, but did not eat it. Place a check in the "Liquids" box each time the person drinks. Thank you. EFTA00035226 EiaALLS*:&31taact_ t_Sak a t a c49,0-2."_ 1:7 -7 - aq-zolef 'rite p 7150114, 5C1,74.- rce -Or0 ,-)e, c51(24pLaticr_c-2151:4-1/4 Asa; meg iberpottn,,bly -7-t2t2tbs-t r psifa;r1 743:17V --6 ',Sep vi lb/ 4.54 - it is ics..N-:75. t (..2812__ Z. CStAtr:G ‘- -ti ii : /41—E F IC-Jer;rt Pi.% EpAcii s 4.S k.' n3 n., ecbra icidei q-itcf,iftzfier-Fo:ei rx, d ,_5 afr.-rte. 9 ,1. -c-; e VT jAic-TIALcaTe:rt ct -&-e--cci)00-1 I 1 ---L ,Y" (7, 3±_p €C 64_11-7/11 Eps ; s ta.7 CrIc5_ 9._uce_cke_oniaL,sufn •-•7legc°94_.th_E4:1412 42.pevcs._AiLiStAiewitAc (et. 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